title: Mortality following hip fracture in men with prostate cancer.
abstract: BACKGROUND
  Hip fractures are associated with increased mortality and are a known adverse effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). It was our aim to evaluate how mortality after hip fracture is modified by PCa and ADT.
  
  
  METHODS
  PCa dataBase Sweden (PCBaSe 2.0) is based on the National PCa Register and also contains age and county-matched PCa-free men. We selected all men (n = 14,205) who had been hospitalized with a hip fracture between 2006 and 2010; 2,300 men had a prior PCa diagnosis of whom 1,518 (66%) were on ADT prior to date of fracture. Risk of death was estimated with cumulative incidence and standardized mortality ratios (SMRs) to make comparisons with the entire PCa population and the general population.
  
  
  RESULTS
  Cumulative incidences indicated that there was a higher risk of death following a hip fracture for PCa men on ADT than for PCa men not on ADT or PCa-free men, particularly in the first year. The SMRs showed that PCa men on ADT with a hip fracture were 2.44 times more likely to die than the comparison cohort of all PCa men (95%CI: 2.29-2.60). This risk was especially increased during the first month (5.64 (95%CI: 4.16-7.48)). In absolute terms, hip fractures were associated with 20 additional deaths per 1,000 person-years in PCa men not on ADT, but 30 additional deaths per 1,000 person-years for PCa men on ADT, compared to all PCa men.
  
  
  CONCLUSIONS
  Hip fractures are associated with higher all-cause mortality in PCa men on ADT than in PCa men not on ADT or PCa-free men, especially within the first three months.
authors.affiliation: King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom ; Institute for Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Mieke
authors.initials: M
authors.lastname: Van Hemelrijck
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.forename: Karl
authors.initials: K
authors.lastname: Michaëlsson
authors.forename: Andreas
authors.initials: A
authors.lastname: Thorstenson
authors.forename: Olof
authors.initials: O
authors.lastname: Akre
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.forename: Jan
authors.initials: J
authors.lastname: Adolfsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006620:Hip Fractures / Q000209:etiology* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D013548:Sweden / Q000453:epidemiology